Introduction: Human immunodeficiency virus (HIV)-associated lipodystrophy syndrome (LS) is defined as a redistribution of adipose tissue, metabolic and endocrine abnormalities, resulting from combined antiretroviral therapy (cART). Aim of this study was to evaluate LS in HIV-infected patients from Lower Silesia, Poland.
Material and methods: One hundred and ten HIV-infected patients on cART for at leat 2 years were included. Two subgroups of patients were established: patients with no or slight symptoms of lipodystrophy – LS1; and patients with moderate and severe changes – LS2. The patients were also divided according to the type of LS: lipoatrophy, lipoaccumulation, both lipoatrophy and lipohypertrophy.
Results: LS2 subgroup was significantly older, had much lower body weight, lower WHR, more advanced atherosclerotic changes. Patients with advanced lipodystrophy syndrome had very high pack-year values. LS1 group had hypertension much more frequently than controls. Comparing with controls, LS2 had significantly lower low-density lipoprotein (LDL) cholesterol, higher triglyceride levels, longer time of HIV infection, longer time of cART and cumulative time on cART (including PIs and NRTIs). A higher current CD4+ T-lymphocyte count and more frequent HCV infection in patients with more severe adipose tissue changes were of little statistical significance. Fat loss of face, limbs, buttocks and together with lipoaccumulation of abdomen were most common.
Conclusions: Lipodystrophy syndrome is still observed in the vast majority of HIV-positive patients receiving antiretroviral therapy, especially those older and with longer time of cumulative NRTI and PI treatment. A great concern is needed to evaluate body composition and risk factors for metabolic changes to prevent their progression and healthy consequences.